MEDICARE: KIRSTEN TROTTER LYNCH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207NS0135X	Procedural Dermatology Physician	35-059669	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	070008210	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114928041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIRSTEN TROTTER LYNCH MD

Provider Business Mailing Address
First Line	:	3737 PARK EAST DR STE 109
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4329
Country	:	US
Telephone Number	:	216-464-7333
Fax Number	:	216-464-2696

Provider Business Practice Location Address
First Line	:	3737 PARK EAST DR
Second Line	:	SUITE 109
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-4347
Country	:	US
Telephone Number	:	216-464-7333
Fax Number	:	216-464-2696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	06/16/2021

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